Cain’s Address Highlights Jacobs School’s Successes

That was the message that Michael E. Cain, MD, vice president for health sciences and dean of the Jacobs School, delivered in celebrating the school’s successes while looking toward more triumphs ahead during this year’s state-of-the-school address, which took place Jan. 30 at the M&T Auditorium at the downtown campus.

“We’re entitled today in January 2020 to say the future of medicine is here,” Cain said. “We don’t aspire it to be here. We’re doing great things and the future of medicine is in fact here in Buffalo at this university.”

Cain stressed the hundreds of people over the past three years who have worked at developing the school’s core strategic plans.

“We have an important mission and we will achieve that mission by developing and inspiring exceptional physicians and scientists through transformative education, to advance research and discovery, to improve health for all, to deliver exceptional, compassionate health care through innovation and integration, to improve health outcomes through interprofessional education, and to strive for preeminence by promoting inclusion, respecting diversity and embracing cultural differences,” Cain said.

“We’ve undertaken an immense effort for curriculum revision, and this is being headed by Lisa Jane Jacobsen, MD, associate dean for medical curriculum, and Jennifer A. Meka, PhD, assistant dean for medical education. This is a multi-year project. We began talking about this two years ago. We began implementing this in June 2019. This is as big a project as it was building this medical school,” Cain said.

“We’ve listened to our stakeholders and during this year we continue to listen to our students, our residents, our faculty, our staff and our hospital partners,” he said.

The entering class of August of 2022 will be the first group that will experience the full version of the continuously redesigned curriculum, Cain added.

“This is a heroic effort, but it is critical and again leads to greatness,” Cain said.

Meka was also brought on as the inaugural director of the Medical Education and Educational Research Institute (MEERI). She oversees the advancement of medical education at the Jacobs School, primarily aimed at medical students.

Since starting in March 2019, she has begun an intensive effort to engage students about their thoughts on the program.

“The individual consultations are impressive. In less than a year, Jennifer and her growing team met with students who were getting prepared for the USMLE Step 1 exam and interviewed 165 of the 177 students who took Step 1 last summer. This was an effective intervention. She’s held over 650 individual meetings with students — and now residents — since joining us,” Cain said.

That has meant a decrease in the number of failures from 2018 to 2019 and increased year-to-year mean and median scores for students, along with having a score higher than the national mean.

Students report improvement in the following areas as a result of participation in the academic support program:

• efficiency and effectiveness of studying
• performance on tests/exams
• confidence in study skills
• confidence in test-taking skills

Cain also emphasized aspects of MEERI that are meant to have a positive effect on students and staff.

“MEERI has recently introduced feel-good moments about acknowledging and thanking people who educate our students well. Instead of having a hotline where you complain about somebody, this is a hotline where you recognize that one of our educators did an outstanding job in the interaction that he or she had with a group of students,” Cain said. “The individual faculty member gets this positive message, the department chair gets this positive message, and I get this very important message.”

While the Jacobs School building opened in November 2017, it had been years in the planning stage.

“Our faculty and the staff had the insight in 2011 when we started preparing and designing this building, that we needed to dramatically change the educational venues and space that was allotted to education,” Cain said.

“Now that the building is open — and we’re in one of our classrooms — we’ve actually increased by 46,722 feet the space dedicated for exchange of information and education for each other,” he adds.

Prior to the opening of the new building, there was 26,292 feet of space. Now there is 73,014, a net increase of 178 percent.

Alan J. Lesse, MD, senior associate dean for medical curriculum, played a key role in the LCME accreditation for the Jacobs School as the faculty accreditation lead.

“Due to the leadership of Alan Lesse and many, many others, we recently completed our accreditation site visit,” Cain said. “We’re fully accredited for the longest period that a medical school can be, which is eight years.”

Presentations to the LCME site visit team detailed the school’s continuous efforts to be compliant with the 12 standards and 96 elements that define critical areas of the medical education curriculum and learning environment.

The next site visit is in the 2026-27 academic year.

Cain also highlighted the success of the Interprofessional Education (IPE) Program, which began in the 2012-2013 school year and involves the five health science schools — medicine and biomedical sciences, dental medicine, nursing, pharmacy and pharmaceutical sciences and public health and health professions — along with social work, law and management.

The program, under the direction of Patricia J. Ohtake, PhD, assistant vice president for interprofessional education — who directs the program with curriculum educators across the eight schools — received the 2019 Program of Merit Award from the Association of Schools Advancing Health Professions.

The IPE Leadership Team has been active with the scholarship of IPE. From 2012 through 2019 there have been five grants, 10 publications and 24 national and international presentations.

“The LCME thought this was one of the best interprofessional education programs that we have in the country,” Cain said.

Created 18 months ago, the Office of Accreditation and Quality Improvement (OAQI) was tasked with continuously monitoring the school’s compliance with the LCME standards and other performance metrics that the school wants to follow, such as Step 1 and Step 2 scores.

Cain praised the OAQI leadership of Daniel W. Sheehan, MD, PhD, associate dean for medical curriculum, and Tanya Biscardi, senior program administrator.

Mean Step 1 scores have gone from 224 in 2015 to 232 in 2019, equaling the national average.

The percent passing Step 1 went from 89 in 2015 to 98 in 2019, surpassing the national average of 97.

Mean Step 2 scores of 243 for academic year 2018-19 equaled the national average, while the percent passing Step 2 was at 97 for 2018-19, just below the national average of 98.

The graduate admissions process changed to a holistic approach for master’s and doctoral candidates in biomedical sciences, similar to medical student applications, Cain explained.

The GRE is no longer considered in the admissions process and the application review focuses on research preparation.

Of the 203 applicants, 65 were invited to interview and 11 were accepted.

“The number of applicants and the quality of that program continues to improve,” Cain said.

Cain also noted that the Office of Graduate Medical Education, under the direction of Roseanne C. Berger, MD, senior associate dean for graduate medical education, has attained institutional accreditation with commendation and no citations for deficiencies.

The school has 67 programs accredited by the Accreditation Council for Graduate Medical Education.

The program includes 764 postgraduate trainees — 610 residents and 154 fellows.

In addition, 16 new program directors have been added in the past 18 months.

“The new directors add an infusion of new ideas into each of these programs,” Cain said.

Once they finish their training, residents tend to increasingly stay in New York State. After completing training, 51 percent stay in New York. The retention rate in New York exceeds the retention for all postgraduate training programs in New York based on data from New York’s Annual Health Workforce Study of graduating residents.

The vast majority of those staying in state are staying in Erie County.

Of 718 residents in 61 programs surveyed, 83 percent had an overall evaluation of the program as being positive or very positive.

During the 2019-20 academic year, funding through the research foundation reached almost $60 million. If you add in research funding procured by full-time faculty working at Roswell Park Comprehensive Cancer Center and the VA Western New York Healthcare System, the total approaches $130 million.

UB’s Clinical and Translational Science Institute (CTSI), under the direction of Timothy F. Murphy, MD, senior associate dean for clinical and translational research, began in 2015 and continues to make its mark on the community.

From 70 clinical trials in 2015, the number grew to 239 in 2019, an increase of 340 percent.

Participants increased from 1,334 in 2015 to 3,414 in 2018; underrepresented minorities grew from 414 in 2015 to 921 in 2018.

The return on investment from the CTSI Pilot Studies Program has also been impressive.

In the 2010-11 academic year, $200,000 was invested in six pilot studies by faculty. To date, they have generated more than $6.3 million of extramural funding.

“It’s an impressive return on investment for a relatively modest support during that critical period of a young investigator’s life,” Cain said.

A children’s book to teach children and parents about clinical research, “Sofia Learns About Research” — created by Teresa Quattrin, MD, senior associate dean for research integration; Renee B. Cadzow, adjunct assistant professor of pediatrics; and Alexandra Marrone, a third-year student in the medical education program — has garnered positive reviews.

“This has been noticed by the National Institutes of Health (NIH) and has attracted substantial national attention,” Cain said. “We’re working with the newly-opened Explore & More Children’s Museum here in Buffalo to have an exhibit on the importance of translational and clinical research in the pediatric population.”

The Jacobs School has worked to identify and develop research areas that are ready for acceleration, and that is shown in the neuroscience program, under the direction of Fraser J. Sim, PhD, associate professor of pharmacology and toxicology.

“The neuroscience program has just blossomed here. It now involves over 100 scientists from six different decanal units,” said Cain, who indicated they are fostering a connection between basic science and clinical research and clinical medicine and the neurodegenerative diseases and aging; addiction; developmental, neuromuscular and demyelating diseases; and diseases of the sensory system.

“Many new NIH grants have resulted from this and significant publications,” Cain added.

The Jacobs School has also partnered with Erie County Medical Center and Kaleida Health on a joint electronic health record and clinical integration model.

“We want to lead patient-centered, quality-driven care and we want to assure comprehensive quality health care services for all,” Cain said.

Collaborations with nursing homes and other health care facilities has allowed the Jacobs School to translate discoveries into clinical care that improves health in Western New York.

The fourth floor of the Conventus Building — a 350,000-square-foot-center for collaborative medicine on the Buffalo Niagara Medical Campus that opened shortly before the Jacobs School building — now hosts 12 practice plans within the UBMD Physicians’ Group.

Conventus’ fifth floor houses academic offices for:

• pediatrics
• obstetrics and gynecology
• child neurology
• pediatric surgery

“The UBMD practice plans over the last 13 years have had a dramatic increase in their clinical revenues,” Cain said. “This is a compliment to Kevin J. Gibbons, MD, senior associate dean for clinical affairs, who oversees our clinical programs, and the 18 chairs of our clinical departments and our hospital partners.”

Revenues for UBMD practice plans have jumped from $138 million in 2007 to $310 million in 2019.

UBMD Conventus patient visits also continue to increase, going from 25,119 in 2017 to 41,657 in 2019.

The Jacobs School has been at the forefront in dealing with the opioid crisis.

Buffalo Matters, through the leadership of Joshua J. Lynch, DO, clinical assistant professor of emergency medicine, changed the way emergency rooms treat those suffering from an opioid overdose. Instead of being sent home after an opioid drug overdose was stabilized and given a list of treatment clinics to call for a follow-up appointment upon being released — which rarely happened — patients now start drug-assisted treatment and book appointments before leaving the hospital.

“This is a program that has revolutionized the emergency department treatment of opioid use by immediately treating patients with buprenorphine and rapidly transitioning them to continuing care with regional treatment agencies,” Cain said.

Cain indicated that the program was highlighted in Gov. Andrew M. Cuomo’s 2020 State of the State address and is being replicated statewide.

Through the efforts of Nancy H. Nielsen, MD, PhD, senior associate dean for health policy, the school hosted a Fulbright symposium on the opioid crisis in April 2019 that attracted nearly 100 international Fulbright scholars. The Jacobs School has been asked to host the 2020 meeting as well.

The number of medical students in the entering class went from 144 to 180 with the opening of the new medical school. To meet the needs of the students, the number of faculty has also grown, from 761 in the 2015-16 academic year to an estimated 837 this academic year.

For the Class of 2023, there were 3,823 applications. Of those, 581 were interviewed to fill the 180 slots.

The academic metrics include an average MCAT score of 510 with an overall GPA of 3.64 and a science GPA of 3.54.

In the Class of 2023, 83 percent are from the state of New York and 17 percent from out of state; 50 percent are from Western New York.

The Office of Communications is continuing to strengthen the school’s websites.

New websites added include:

• Department of Emergency Medicine
• Department of Neurosurgery
• Department of Surgery
• Early Assurance Program
• Emergency Psychiatry Fellowship
• UB RISE
• Office of Accreditation and Quality Improvement
• Facilities Planning and Management

The office produced 166 news stories in 2019. Of those, 74 highlighted faculty research, 43 highlighted achievements of residents, fellows and medical students, and five spotlighted 75 faculty members who are new to the Jacobs School. There were 553 media mentions showcasing external media coverage highlighting faculty.

In all, there are 18,000-plus pages of site content, with 37 percent of those pages being updated in 2019. The school’s website generated 2,710,195 page views, almost triple the amount from four years ago.

“We are achieving greatness — but we have more to achieve. This has been a remarkable group of people to work with — those inside the school and the university and our off-campus collaborators and our health systems in the community. I think we have made incredible progress,” Cain said.

In other news, Cain reported:

• Five departments have new chairs since the move downtown: pharmacology and toxicology — David Dietz, PhD; dermatology — Lori E. Ullman, MD; pediatrics — Steven E. Lipshultz, MD; obstetrics and gynecology — Sarah Berga, MD (starting in June 2020); physiology and biophysics — Mikhail V. Pletnikov, MD, PhD (starting in July 2020).
• The school has also reached out to new potential donors through a grateful patient philanthropy organization to ethically solicit donations from patients they have taken care of. The program raised $1.5 million in 2018 and $1.27 million in 2019.